SURVEILLANCE FOR THROMBOCYTOPENIA IN PERSONS INFECTED WITH HIV - RESULTS FROM THE MULTISTATE ADULT AND ADOLESCENT SPECTRUM OF DISEASE PROJECT

Thrombocytopenia in persons infected with HIV is prevalent and has num erous causes. To study the occurrence, associations, and effect on sur vival of thrombocytopenia in HIV-infected persons, we used surveillanc e data from a longitudinal survey of the. medical records of 30,214 HI V-infected patients who received medical care from January 1990 throug h August 1996 in more than 100 medical clinics in 10 U.S. cities, Thro mbocytopenia was defined as a physician diagnosis of thrombocytopenia or a platelet count of <50,000 platelets/mu l. Analysis of association s of thrombocytopenia was conducted using logistic regression. In HIV patients, the 1-year prevalence of thrombocytopenia was 8.7% in perso ns with one or more AIDS-defining opportunistic illnesses (clinical AI DS), 3.1% in patients with a CD4 count <200 cells/mm(3) but not clinic al AIDS (immunologic AIDS), and 1.7% in persons without clinical or im munologic AIDS, The incidence of thrombocytopenia was associated with clinical AIDS (adjusted odds ratio [AOR] 2.2; 99% confidence interval [CI] 1.7-3.0). immunologic AIDS (AOR 1.5, CI 1.0-2.1), history of inje cting drug use (AOR 1.4, CI 1.0-1.9), anemia (AOR 5.0, CI 3.8-6.7), ly mphoma (AOR 3.7, CI 1.3-10.6), and black race (AOR 0.7, CT 0.5-0.9). A fter controlling for anemia, clinical AIDS, CD4 count, neutropenia, an tiretroviral therapy and Pneumocystis carinii pneumonia prophylaxis, t hrombocytopenia was significantly associated with decreased survival ( risk ratio 1.7; 95% CI, 1.6-1.8). Thrombocytopenia in HIV-infected per sons is an important clinical condition associated with shorter surviv al.